The Experts below are selected from a list of 123 Experts worldwide ranked by ideXlab platform
Alberto Tagliafico - One of the best experts on this subject based on the ideXlab platform.
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Update on Ultrasound-Guided Interventional Procedures on Peripheral Nerves.
Seminars in musculoskeletal radiology, 2016Co-Authors: Alberto Tagliafico, Bianca Bignotti, Carlo MartinoliAbstract:This article is a practical review update on ultrasound (US)-guided interventional procedures on peripheral nerves. Technical considerations, biopsy techniques, and some examples of injections are described. US is considered a safe imaging guidance for interventional procedures, due to its high spatial resolution and the possibility to image the needle and inject drugs in real time. US-guided injections could be considered a diagnostic and therapeutic option in the most common neuropathy, before or as an alternative to surgery. US-guided injection techniques in patients with carpal tunnel syndrome, cubital tunnel syndrome, meralgia paresthetica, and Morton Neuroma are reviewed. US-guided injections of the iliohypogastric, ilioinguinal, genitofemoral, and pudendal nerve are also illustrated. Knowledge of anatomy is crucial; therefore a brief description of the courses of anatomical nerves and clinical notes are also reported. Treatment of stump Neuromas treatment was excluded.
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Ultrasound versus magnetic resonance imaging for Morton Neuroma: systematic review and meta-analysis
European Radiology, 2015Co-Authors: Bianca Bignotti, Carlo Martinoli, Alessio Signori, Maria Pia Sormani, Luigi Molfetta, Alberto TagliaficoAbstract:Objectives To compare ultrasound (US) and magnetic resonance imaging (MRI) in the diagnosis of Morton’s Neuroma. Methods Studies that assessed the diagnostic accuracy of US and MRI for Morton’s Neuroma were retrieved from major medical libraries independently by two reviewers up to 1 April 2014. Predefined inclusion and exclusion criteria were adopted. Results 277 studies were initially found, and the meta-analysis was conducted on 14 studies. US sensitivity was studied in five studies, MRI sensitivity in three studies, and bothin six studies. All studies used surgery as the reference standard. A high sensitivity (SE) of diagnostic testing was observed for both US (SE (95 % CI) = 0.91 (0.83–0.96)) and MRI (SE (95 % CI) = 0.90 (0.82–0.96)) with no significant differences between the two modalities in diagnosis (Q test p = 0.88). For MRI, specificity of test was 1.00 with a pooled estimation of 1.00 (0.73–1.00), while the pooled specificity was 0.854 (95 % CI: 0.41–1.00) for US. No differences were observed between US and MRI in study design (p = 0.76). Conclusion This meta-analysis shows that the SE of US (0.91) is equal to (p = 0.88) that of MRI (0.90) for identification of Morton’s Neuroma. Key points • For Morton’s Neuroma, US sensitivity is equal to MRI. • US is as accurate as MRI in diagnosing Morton’s Neuroma. • US may be the most cost-effective imaging method for Morton’s Neuroma.
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ultrasound versus magnetic resonance imaging for Morton Neuroma systematic review and meta analysis
European Radiology, 2015Co-Authors: Bianca Bignotti, Carlo Martinoli, Alessio Signori, Maria Pia Sormani, Luigi Molfetta, Alberto TagliaficoAbstract:Objectives To compare ultrasound (US) and magnetic resonance imaging (MRI) in the diagnosis of Morton’s Neuroma.
Bianca Bignotti - One of the best experts on this subject based on the ideXlab platform.
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Update on Ultrasound-Guided Interventional Procedures on Peripheral Nerves.
Seminars in musculoskeletal radiology, 2016Co-Authors: Alberto Tagliafico, Bianca Bignotti, Carlo MartinoliAbstract:This article is a practical review update on ultrasound (US)-guided interventional procedures on peripheral nerves. Technical considerations, biopsy techniques, and some examples of injections are described. US is considered a safe imaging guidance for interventional procedures, due to its high spatial resolution and the possibility to image the needle and inject drugs in real time. US-guided injections could be considered a diagnostic and therapeutic option in the most common neuropathy, before or as an alternative to surgery. US-guided injection techniques in patients with carpal tunnel syndrome, cubital tunnel syndrome, meralgia paresthetica, and Morton Neuroma are reviewed. US-guided injections of the iliohypogastric, ilioinguinal, genitofemoral, and pudendal nerve are also illustrated. Knowledge of anatomy is crucial; therefore a brief description of the courses of anatomical nerves and clinical notes are also reported. Treatment of stump Neuromas treatment was excluded.
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Ultrasound versus magnetic resonance imaging for Morton Neuroma: systematic review and meta-analysis
European Radiology, 2015Co-Authors: Bianca Bignotti, Carlo Martinoli, Alessio Signori, Maria Pia Sormani, Luigi Molfetta, Alberto TagliaficoAbstract:Objectives To compare ultrasound (US) and magnetic resonance imaging (MRI) in the diagnosis of Morton’s Neuroma. Methods Studies that assessed the diagnostic accuracy of US and MRI for Morton’s Neuroma were retrieved from major medical libraries independently by two reviewers up to 1 April 2014. Predefined inclusion and exclusion criteria were adopted. Results 277 studies were initially found, and the meta-analysis was conducted on 14 studies. US sensitivity was studied in five studies, MRI sensitivity in three studies, and bothin six studies. All studies used surgery as the reference standard. A high sensitivity (SE) of diagnostic testing was observed for both US (SE (95 % CI) = 0.91 (0.83–0.96)) and MRI (SE (95 % CI) = 0.90 (0.82–0.96)) with no significant differences between the two modalities in diagnosis (Q test p = 0.88). For MRI, specificity of test was 1.00 with a pooled estimation of 1.00 (0.73–1.00), while the pooled specificity was 0.854 (95 % CI: 0.41–1.00) for US. No differences were observed between US and MRI in study design (p = 0.76). Conclusion This meta-analysis shows that the SE of US (0.91) is equal to (p = 0.88) that of MRI (0.90) for identification of Morton’s Neuroma. Key points • For Morton’s Neuroma, US sensitivity is equal to MRI. • US is as accurate as MRI in diagnosing Morton’s Neuroma. • US may be the most cost-effective imaging method for Morton’s Neuroma.
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ultrasound versus magnetic resonance imaging for Morton Neuroma systematic review and meta analysis
European Radiology, 2015Co-Authors: Bianca Bignotti, Carlo Martinoli, Alessio Signori, Maria Pia Sormani, Luigi Molfetta, Alberto TagliaficoAbstract:Objectives To compare ultrasound (US) and magnetic resonance imaging (MRI) in the diagnosis of Morton’s Neuroma.
M Zanetti - One of the best experts on this subject based on the ideXlab platform.
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Morton Neuroma mr imaging after resection postoperative mr and histologic findings in asymptomatic and symptomatic intermetatarsal spaces
Radiology, 2010Co-Authors: Norman Espinosa, Juergen Wilfried Schmitt, Nadja Saupe, Gerardo Juan Maquieira, Beata Bode, Patrick Vienne, M ZanettiAbstract:Morton Neuroma–like abnormalities are commonly seen on MR images after Morton Neuroma resection, and although these abnormalities are larger in patients with symptoms, there is a high degree of size overlap; therefore, it is difficult to differentiate between symptomatic and asymptomatic patients.
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mr imaging of the forefoot Morton Neuroma and differential diagnoses
Seminars in Musculoskeletal Radiology, 2005Co-Authors: M Zanetti, Dominik WeishauptAbstract:Magnetic resonance (MR) imaging of Morton Neuromas is highly accurate. Morton Neuromas are more conspicuous when the patient is prone positioned and the foot is plantar flexed than in the supine position with the toes pointing upward. MR imaging of Morton Neuromas has a large influence on the diagnostic thinking and treatment plan of orthopedic foot surgeons. The most common differential diagnoses include intermetatarsal bursitis, stress fractures, and stress reactions. Some diagnoses (nodules associated with rheumatoid arthritis, synovial cyst, soft tissue chondroma, and plantar fibromatosis) are rare and can be diagnosed with histologic correlation only.
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Morton Neuroma mr imaging in prone supine and upright weight bearing body positions
Radiology, 2003Co-Authors: Dominik Weishaupt, Hanspeter Kundert, Hans Zollinger, Juerg Hodler, Karl Treiber, Patrice Vienne, Jurgen K Willmann, Borut Marincek, M ZanettiAbstract:PURPOSE: To assess the effect of prone, supine, and upright weight-bearing body positions on visibility, position, shape, and size of Morton Neuroma during magnetic resonance (MR) imaging. MATERIALS AND METHODS: Eighteen patients with 20 Morton Neuromas underwent MR imaging of the forefoot in prone (plantar flexion of the foot), supine (dorsiflexion of the foot), and upright weight-bearing positions. Visibility (3 = good, 2 = moderate, 1 = poor), position relative to the metatarsal bone, shape, and transverse diameter of Morton Neuroma were assessed on transverse T1-weighted MR images. Associations between different body positions and variables of interest were calculated with Wilcoxon signed rank test, χ2 test, and paired Student t test. RESULTS: In the prone position, visibility of all 20 Morton Neuromas was rated with a score of 3; visibility in the supine and weight-bearing positions was inferior (mean score, 2.4). All 20 (100%) Morton Neuromas changed their position relative to the metatarsal bone be...
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Morton Neuroma effect of mr imaging findings on diagnostic thinking and therapeutic decisions
Radiology, 1999Co-Authors: M Zanetti, Josef K Strehle, Hanspeter Kundert, Hans Zollinger, Juerg HodlerAbstract:PURPOSE: To determine the effect of magnetic resonance (MR) imaging results on diagnostic thinking and therapeutic decisions by orthopedic surgeons in cases of a possible Morton Neuroma. MATERIAL AND METHODS: Orthopedic surgeons completed a questionnaire before and after MR imaging for 54 feet in 49 patients thought to have Morton Neuroma. Clinical diagnosis (Morton Neuroma, differential diagnosis), location, diagnostic confidence, and therapeutic decisions were noted before and after MR imaging. The influence of the size of the Neuroma on therapeutic decisions was analyzed. MR imaging diagnoses were compared with surgical results for 23 revised intermetatarsal spaces. RESULTS: After MR imaging, the clinical diagnosis of Morton Neuroma was withdrawn in 15 of 54 (28%) feet. In 14 of 39 maintained diagnoses, the location or number of Neuromas was changed after MR imaging. Confidence levels for Morton Neuroma increased substantially after MR imaging. In 31 (57%) feet, a change in treatment plan resulted after MR imaging. Diameters of Neuromas on MR images were significantly larger (P = .003) in surgically treated feet than in conservatively treated feet. MR imaging diagnoses were correct in all 23 revised intermetatarsal spaces. CONCLUSION: MR imaging has a major effect on diagnostic thinking and therapeutic decisions by orthopedic surgeons when Morton Neuroma is suspected, especially because MR imaging helps in localization and size assessment of Morton Neuromas.
Wolfgang Schneider - One of the best experts on this subject based on the ideXlab platform.
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Surgical treatment of Morton's Neuroma: clinical results after open excision
International Orthopaedics, 2013Co-Authors: Maximilian F Kasparek, Wolfgang SchneiderAbstract:Purpose Long-term results following surgical treatment of Morton Neuroma are rare. The purpose of the present study was to evaluate patients after excision of Morton’s Neuroma at least ten years following surgery. Methods We performed a retrospective review of the patients’ records who underwent excision of an interdigital Neuroma with the clinical diagnosis of Morton’s Neuroma. Eighty-one patients who had undergone surgery on 98 feet were analysed at an average of 15.3 years postoperatively. In total 111 Neuromas were excised, because in 13 feet more than one Neuroma was identified clinically. Follow-up evaluation included physical examination and a radiographic evaluation. The interdigital Neuroma clinical evaluation score and the AOFAS score were assessed. Results An excellent result was reported for 44 feet (44.9 %), a good result for 31 feet (31.6 %) and a fair one for 15 feet (15,3 %). Eight feet had a poor result (8.2 %), in all of them an amputation Neuroma was diagnosed. The average Neuroma score was 62 points (range 20–80) and the AOFAS score 75 points (range 29–100). Sixty-one feet (62.2 %) had concomitant foot and ankle disorders not related to the primary diagnosis of Morton’s Neuroma. Numbness was assessed in 72 % (72 feet), a normal sensibility in 26 % (26 feet) and dyaesthesia in 1 % (one foot). The clinical outcome was not influenced by existence of sensory deficits ( p = 0.646); analysis of location of Neuroma showed best results for those in the third webspace. A significantly worse outcome was found in patients operated on multiple Neuromas compared to single Neuroma ( p = 0.038). Conclusion Surgical excision of a Morton’s Neuroma results in good clinical results and high overall patient’s satisfaction in the long term. Multiple Neuromas have worse outcome than single Neuromas. Sensory deficits and concomitant foot and ankles disorders are common, but do not have an influence on patient’s satisfaction.
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surgical treatment of Morton s Neuroma clinical results after open excision
International Orthopaedics, 2013Co-Authors: Maximilian F Kasparek, Wolfgang SchneiderAbstract:Purpose Long-term results following surgical treatment of Morton Neuroma are rare. The purpose of the present study was to evaluate patients after excision of Morton’s Neuroma at least ten years following surgery.
Alberto Martínez Martínez - One of the best experts on this subject based on the ideXlab platform.
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Short term comparison between blind and ultrasound guided injection in Morton Neuroma
European Radiology, 2018Co-Authors: Fernando Ruiz Santiago, Nicolás Prados Olleta, Pablo Tomás Muñoz, Luis Guzmán Álvarez, Alberto Martínez MartínezAbstract:Objective The aim of this work is to compare the effectiveness of blind and ultrasound-guided injection for Morton’s Neuroma (MN) to determine which is more appropriate as the initial procedure in conservative treatment. Methods This is an evaluator-blinded randomised trial. Of the 56 included patients, 27 were assigned to the blind group (A) and 29 to the ultrasound-guided group (B). Injection includes 1 ml of 2% mepivacaine and 40 mg of triamcinolone in each web space with MN. The included patients were assessed clinically by VAS score and the Manchester Foot Pain and Disability Score (MFPDS). The follow-up was performed at 15 days, 1 month, 45 days, 2 months, 3 months and 6 months after the initial injection. Results No differences in age or clinical measurements were found at presentation between group A and group B. At the follow-up, the ultrasound-guided group showed greater symptomatic relief at several stages of the follow-up: 45 days (VAS 3.0 ± 0.5 versus 5.5 ± 0.5, p = 0.001; MFPDS: 32.2 ± 1.8 versus 38.8 ± 2.0, p = 0.018), 2 months (VAS: 3.1 ± 0.5 versus 5.6 ± 0.5, p = 0.002; MFPDS: 31.5 ± 1.9 versus 38.5 ± 2.1, p = 0.020) and 3 months (VAS: 3.1 ± 0.4 versus 5.2 ± 0.6, p = 0.010; MFPDS: 31.2 ± 1.9 versus 37.7 ± 2.4, p = 0.047). Conclusion Injection of MN under ultrasound guidance provides a statistically significant improvement at some stages of the follow-up (45 days, 2 and 3 months), compared with blind injection. Key Points • Ultrasound-guided steroid injections in Morton’s Neuroma provide short-term pain relief to over 60% of the patients. • Ultrasound-guided injections in Morton’s Neuroma lead to a higher percentage of short-term pain relief than blind injections. • Ultrasound-guided injections in Morton’s Neuroma lead to a lower percentage of skin side effects than blind injections.